Healthcare Provider Details

I. General information

NPI: 1912860552
Provider Name (Legal Business Name): SUNNY SMILES PEDIATRIC DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9612 FM 1488 SUITE 300
MAGNOLIA TX
77354
US

IV. Provider business mailing address

21283 HIDDEN BEND LOOP
MAGNOLIA TX
77354-4267
US

V. Phone/Fax

Practice location:
  • Phone: 291-728-4228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HILARY TANDY
Title or Position: SOLE MEMBER
Credential:
Phone: 281-728-4228